The summer weather has surprised us and made getting your daily dose of vitamin D that much easier. But the sunny weather always prompts questions about how to enjoy it safely.
Most people know there’s a balance to be struck when it comes to spending time out in the sun. Its UV rays that are the main cause of skin cancer, but we also need some sunshine to generate vitamin D.
Although the number of children getting rickets from low vitamin D levels is still relatively small, in recent years it has increased slightly, suggesting some people may not be spending enough time outside. But skin cancer is also on the increase, for example almost 16,000 people are diagnosed with melanoma every year.
The amount of sun you need to generate enough vitamin D varies depending on your skin. But it has been unclear how long people might need to spend in the sun to generate enough vitamin D while minimising their skin cancer risk.
That’s where research from Professor Lesley Rhodes, at the University of Manchester, comes in.
Is there a safe level of sun exposure?
In an in-depth Cancer Research UK-funded study, Rhodes and her team looked at the impact of exposing 39 people of different skin types to low levels of UV. Would that be enough to generate vitamin D? And will this cause DNA damage in their cells that could lead to skin cancer?
Unlike previous studies, Rhodes gave participants UV doses related to their burning risk.
As the dose of UV increased towards their individual burning level, there was an increase in both vitamin D levels and DNA damage seen in skin samples. For all skin types these factors seem to be completely intertwined.
What about different skin types?
One motivation for Rhodes is understanding more about difference between skin types. “Quite a lot of information has been gathered on white-skinned people, but there’s been very little for people with darker skin. We needed to firm up our knowledge by looking at the major benefit and the major harm of sunlight at the same time in each person.”
Interestingly, the findings differed by skin type when the researchers looked at the lower layer of the skin, where damage is most dangerous. For darker skin types DNA damage wasn’t detected at this lower level, it was mostly at the surface. In lighter skin types DNA damage was found throughout the layers, meaning there was more potentially dangerous damage lower down.
“This was a really novel discovery, that the darker the skin colour the closer the DNA damage was to the surface” says Rhodes.
Regardless of dose or skin type, the DNA damage was no longer present 48 hours later. Our bodies can deal with some level of DNA damage and the level of damage in the study seemed to be low enough to be cleared shortly after. Although this is reassuring, the study can’t rule out the possibility that damage like this could go on to cause problems. And Rhodes is keen to study this more in the future.
What does this mean for people?
The findings suggest there’s DNA damage happening before skin burns and that it may be more likely to lead to problems in lighter skin types than darker ones. Larger studies will be needed to confirm those results.
“People with darker skin can be encouraged to expose their skin to the sun, without burning, to get vitamin D with very low risk of skin cancer,” says Rhodes. “However, for people with lighter skin who are easy burners we’ve shown even very low doses of UV radiation, down to one fifth of their sunburn threshold, can unfortunately damage the cells in lower layers of the skin.”
There may not be a totally safe level of exposure to the sun when it comes to DNA damage and skin cancer risk, but we also need some sunshine to make vitamin D. Rhodes’ next question was how long do we need to spend in the sun to make enough?
Minutes not hours
“We wanted to define a fairly straight-forward formula for how much sunlight people would need in the UK to get enough vitamin D,” says Rhodes. “People are always asking ‘how much?’, but it’s not quite as simple as just talking about minutes, you also need to look at what area of skin you need to expose and at what time of day.”
To do this, she teamed up with Professor Ann Webb, a physicist with expertise in the atmosphere and sunlight. Together, they modelled the level needed by the end of summer for most people to have enough vitamin D throughout winter, when the sun isn’t strong enough for us to make vitamin D in the UK.
They estimated that 9 minutes of lunchtime sunlight each day would be enough for Caucasians to stay above the ‘deficient’ category of vitamin D level throughout the year. This figure assumes that people would be in shorts and t-shirts for June to August, while only having their hands and faces exposed from March to June and for September.
Our bodies start to break down vitamin D when we’re generating a lot of it so you can’t do a week all in one go. Little and often does seem to be the key.
With the same conditions, even people with darker brown skin that hardly ever burns and easily tans – such as people of South Asian origin –and may only need 25 minutes.
Not a prescription
The studies were based on several specific assumptions. For example, they considered exposure to sun in the UK without sunscreen, accounting for UK weather and no travel abroad. But they can help to give us a broad idea. As Rhodes says: “Some assumptions have to be made but we tried to look at something that was realistic. After this 9 minutes is when sun protection becomes key.”
But if you’re concerned about your vitamin D levels, or your family’s, you may only need to find a few minutes outside at lunchtime each day. Like almost everything else in our daily lives, it won’t be completely risk-free, but it should give a healthy balance.
“People often think it’s a balance between getting enough vitamin D and avoiding skin cancer,” says Rhodes. “But our feeling is that quite often people may be justifying too much time in the sun in order to get their vitamin D. So it’s important to give people the information.
Nikki Smith is a health information manager at Cancer Research UK
Bernard Jordan September 16, 2018
As I suffer from solar Keratosis, I would like to know what safe levels of exposure you would recommend to get the correct level of vitamin D?
Billy Foster September 12, 2018
Not much help to people like me that can’t take the sun because I break out in severe lupus rashes.
Katie Roberts September 10, 2018
Thanks for your comment. If your husband is concerned that he is not getting enough Vitamin D, he should speak to his doctor because he may need to take a Vitamin D supplement. His doctor will be able to give him advice that takes his medical history into account, but you can find general advice on Vitamin D supplements on the NHS website. https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/
Katie, Cancer Research UK
Katie Roberts September 10, 2018
Thank you for your comment. This study didn’t look at exposure for different times of day. They modelled exposure at midday because that is when UV rays are strongest and vitamin D production is most effective. Earlier or later in the day, UV rays would be weaker and potentially less damaging, but vitamin D production would be less effective. There are some risks to taking too much vitamin D in supplements, you can read more about this on the NHS website https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/. You should speak to your doctor to help you decide if you are thinking about taking vitamin D supplements.
Katie, Cancer Research UK
David Reaves September 10, 2018
Is short mid-day exposure better than longer off-peak exposure? Would that give the required vitamin D with lower risk of DNA damage, or are the two effects closely linked at all levels of exposure? I am left wondering if there are any negatives in taking pills rather than exposing skin.
Brenda September 10, 2018
My husband has had skin cancer removed. He avoids the sun like the plague, long sleeved shirts, hat and factor 50 if he has to go in the sun, works inside from early morning till evening, should he be taking vit D, he is on medication for valve blockage in his heart
Cameron L.Smith MD FAAD August 24, 2018
Very little UVB in winter. Moreover, I don’t think many people can stroll outside very often.
Thomas Larry Smith , M.D. August 8, 2018
Prophets of the bleeding obvious. DNA damage starts to happen in the first millisecond of sun exposure . Keep in mind that a large percentage of the fair-skinned population has only one good copy of the DNA repair gene , and that oral Vit D works just fine.
Doc Mills August 6, 2018
So there is such a thing as a “healthy tan”